Individual
MARYAM HEYDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1232 FOURIER DR STE 101, MADISON, WI 53717-1960
(608) 690-8256
Mailing address
1232 FOURIER DR STE 101, MADISON, WI 53717-1960
(608) 690-8256
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1397-140
WI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/17/2024
Last updated
05/29/2025
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